How do you control escalating incidents of anger, violence toward nursing care staff, spouse, and other residents for a dementia patient?

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My mother was sweet and fun-loving throughout her life, but is now angry and violent, becoming more so as her dementia worsens. When family members are present and she is engaged in an activity, she is nice, like she always was. but as soon as we leave, she becomes depressed and angry, pulling my father out of his wheelchair, attacking nursing staff, and yelling angrily. Many medications and dosages have been tried without success. The nursing staff is on a 3:1 ratio to patients, yet, there is simply not enough family and staff to be with her all day. All children live out of state.

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Tell the hospital staff and she may need to see a psychiatrist.
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Johnny J your answer is spot on took 31 days in a bahavioral center to get my husband on the correct meds 2 years and counting he's at home and no change of meds. My answer to the question is those with AD tend to mimic what they see if I am happy husbands happy if I'm mad he becomes out of control, so something your mother is seeing/hearing when you are not there is what is setting her off.
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My mother is 102 and has outbursts like a 3 year old child. I know it is her dementia but I have to set boundaries to keep my sanity. She will not take any medicine and the doctors will not give her antidepressants because of the side affects. I find some change in her behavior when I treat her as a 3yr old child. When she complains nonstop about her food or the nurses care or me, I give her a lecture on "appreciation" and if that doesn't work I leave and tell her she needs to treat people with respect. One time she asked me to bring her a hamburger and french fries from her favorite restaurant and when that wasn't good enough for her I threw it in the trash. She had no choice but to to eat the facility food, and she stopped her angry outburst. It's sad but sometimes I feel it is an attention game where she has control. She used to enjoy social committee organizing and now she treats people as though they were part of her committee. She barks out orders and when something doesn't please her she gets very angry. I don't have a mother daughter relationship with her any more (long gone) and if I bring up something from the past she gets confused..
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One point that was clear to me is that your mother does not behave that way when her children are present. Often seniors with dementia are childlike and are capable of manipulation to get what they want just like a toddler may throw a tantrum to get what they want. It sounds as if she wants her children around her and becomes upset when they leave. I have friends who have had caregivers come into the home to provide care for their parent when they are working. A few of the parents find ways to try and get rid of the aides or resort to bad behavior to accomplish this goal. Since your mother's behavior is not consistently the same when her children are present, I am not entirely sure that medication is the only answer. I wish you the best.
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I know this sounds too simple but it works with my Pop. I do two thiings. I put in a turn on a video of a family gathering and he sits down and is happy again. He never tires of seeing it. The other thing I do is put on some big band music. My Pop loves it and sometimes dances and signs along. I don't know if it would work for anyone else.
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Does your Mom have a neurologist or geriatric specialist like a geri psychiatrist? Most of the time, these changes in behavior can be turned around with a new drug or change in dosage if she is already on any of the psych drugs used for the dementias. And, as is discussed in the forum a lot....any agitation that suddenly shows up, brings to mind a check for a urinary tract infection. For some reason, in any elderly, a bladder or kidney infection brings on very bizarre behaviors and once the infection is controlled, the behavior goes back to normal. Check into these possibilities....
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The senior behavioral center Babalou referred to was the geriatric psych ward at a nearby hospital. I brought my friend Beth there when she would not let staff clean her up due to her incontinence. They started with the drug most likely to succeed in calming her without making her dopey and eased into it a little at a time. If it doesn't work, they eased back out and tried another. It took 3 1/2 weeks to find a combination of drugs that would work for her and she was able to return to her memory care apartment in an assisted living place until she passed away. As her dementia worsened, they were able to reduce the level of drugs in steps with the o.k. from her doctor. That way, the drugs were not contributing to her demented state. Her health insurance paid for the hospital stay. Best of luck dealing with this. And may you find the help you need. I was grateful there were answers for me as Beth's DPOA.
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Yes, as many of us have experienced we see the personality changes turn your loved one into someone they've never seen before....however, it is not THEM, it is the disease !!! Everytime I get frustrated or appalled at their behavior, I realize I have to STOP and take a really good look at the situation...every time I see that it is the disease... . try looking thru their eyes and you will get some really good honest insight as to what they 'see', even though you don't KNOW how they feel, you can get a pretty good idea they can't be feeling very good to say the least.....they may have glimpses of their outlook - impending loss of knowledge of everyone/thing they've ever known, loved ones wiped out of their minds, can't even clean themselves, or feed themselves much less swallow...or breathe....and then the impending death....God save us all with this...this is when you actually hope for their peace and that they pass softly away as they sleep....it is pure torment to watch this in my parents as I'm sure you all experience too....ease them as best you can and suck it up when they have a temper tantrum or say mean and hurtful things....yep, I've been there and just do the best you can for as long as you can. When you just can't do it anymore, then let the professionals take over. I've still got some 'thick skin' left for awhile...who knows, once they aren't able to talk or throw things or have you running around all the time, it may possibly be easier to take care of them as sad as it may be but I think that may be true. I don't know for sure yet, but I'm trying to prepare myself for that stage...i know it will still be devastating, but you can see it coming...ease them, love them, bite your dang tongue, and hang in there for as long as you can. They need to see a familiar face for as long as they can know who you are....
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It is so heart-wrenching to see such changes. Staff should be able to care for your mom. It is a common phenomenon:anger,violent behavior,attacking persons. Staff is trained to deal with this.It is their responsibility to deal with your mother.
Your mom is not responsible...this is all part of this disease.This is not the mother you knew. It is sad. Take care of yourself. thinking of you,Malachy
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Another possibility is a stay in a Senior Behavioral Center where they can get her stabilized on meds. Several posters have taken this route and had success with it.
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